Preventive Measures

How Not To Spend Your Two-week Vacation On Foreign Soil In The Sickroom.

July 05, 1989|By Jane E. Brody, New York Times News Service.

Along with whales and wildebeest, jungles and icebergs, museums and mountains, every foreign trip I have taken has produced its share of medical memories.

Fortunately, all the ills were minor, or at least curable, and none forced a curtailment of my vacation. But that fact did not lessen my suffering-albeit temporary-from chigger bites, nausea, diarrhea, sunburn, bruises, backaches, sprains and prolonged abdominal pains.

Travelers seeking fun and adventure, or just rest and recreation, should not be discouraged, however, since most such problems can be avoided by the vigilant traveler.

To protect their health while abroad, prudent travelers should take these factors into account:

Food and drink

Drink only commercially bottled and sealed beverages or water that has been boiled or treated.

The safest bets are carbonated beverages, hot coffee and tea, beer, wine or liquor, but no ice. Also use bottled water for all personal uses, like brushing your teeth.

Eat foods that are well-cooked and served hot. Pasteurized dairy products should be safe from the bacteria that cause brucellosis, a potentially severe infection.

Now I know why, on our African safari, we were served only milk powder reconstituted with boiled water.

Lest you think diarrhea is the only hazard and a tolerable one at that, unsafe food or drink can also cause infectious hepatitis, the symptoms of which may not develop for a month or more after infection.

If, like me, you think life without a variety of fresh fruits and vegetables is not worth living, try those that you can peel yourself, like oranges, bananas, pineapples, melons, mangoes and papaya.

All types of cooked vegetables should also be safe.

The lettuce, tomatoes, plums and nectarines may be especially tempting, especially when they look as luscious as they do in a tropical country. But they may cause distress.

You should also resist the temptation of prepared foods sold from stands in open-air markets and on the street.

Bathing and walking

Salt water swimming is usually safe.

If you should wind up in lakes or rivers in developing countries, towel off vigorously immediately after. The water may harbor all kinds of parasites like schistosomes and liver flukes.

Wear shoes or sandals when walking anywhere outdoors because some parasites can enter through the feet.

Bites and stings

Use insect repellent (DEET in concentrations of 38 percent or higher)

when outdoors in rural or suburban areas.

Avoid using perfume or scented soaps or lotions that might attract insects.

In grassy areas, be sure to apply repellent to your legs and keep them covered to reduce the risk of chigger bites, which can cause torturous itching for weeks.

Check your entire body nightly for ticks.

Clothing

Before slipping into your shoes, socks or sleeping bags, check for unwanted visitors like scorpions or snakes.

In hot sunny places, on water and at high altitudes, wear a hat and long sleeves to reduce the risk of sunburn and heat stroke.

Altitude

Even the most vigorous traveler is susceptible to illness induced by too- rapid ascents to high altitudes. And those with heart or lung disorders are especially endangered.

If you land at an altitude of 10,000 feet or higher, rest there for a day or two before climbing farther.

A gradual climb, taking at least a day for each 1,000-foot increment from 10,000 to 14,000 feet and two days for every 1,000 feet thereafter, is the secret to reaching the top safely.

Even if you are not climbing, if your plane ride takes you from sea level to 5,000 or more feet, you would be wise to avoid vigorous exertion, alcohol and cigarettes for a few days.

Finding a physician

If you need medical care while abroad but did not come prepared with a list of English-speaking physicians, call the U.S. Embassy or consulate or consular agency in the area. In off-duty hours, the duty officer can provide the names of physicians in the area.

Once you are home

If you develop any kind of symptoms that have no easy explanation within weeks or months of returning home from a foreign country, see your physician without delay and be sure to mention where you have been. -